摘要
目的 探讨基于肺部感染控制窗(PIC-W)结合自主呼吸试验(SBT)时机下行序贯机械通气治疗慢性阻塞性肺病急性加重期(AECOPD)患者的临床研究,为临床应用提供指导。方法 对笔者所在医院重症监护室(ICU)收治的86例行有创-无创序贯机械通气治疗的COPD急性加重期患者进行回顾性分析,根据切换点的选择分为对照组43例,选择PIC确定有创-无创序贯机械通气治疗时机,实验组43例选择PIC-W+SBT确定有创-无创序贯机械通气治疗时机。比较两组治疗效果。结果 两组患者治疗后FEV1、FVC值、PaCO_(2)、SaO_(2)显均高于治疗前,且实验组高于对照组(P<0.05);实验组治疗后PaO_(2)值、再次插管率、死亡率及并发症发生率均低于对照组(P<0.05);实验组机械通气总时间、ICU住院时间均短于对照组(P<0.05)。结论 基于肺部感染控制窗结合自主呼吸试验时机下行序贯机械通气治疗慢性阻塞性肺病急性加重期患者耐受性好,降低再次插管率、病死率,且在改善肺功能、血气指标及降低并发症方面具有积极作用,可在临床上推广应用。
Objective To explore the clinical study of sequential mechanical ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)based on pulmonary infection control window(pic-w)and spontaneous breathing test(SBT).Methods A retrospective analysis was conducted on 86 patients with acute exacerbation of COPD treated with invasive non-invasive sequential mechanical ventilation in the intensive care unit(ICU)of the author's hospital.According to the selection of switching points,43 patients were divided into a control group,and PIC was selected to determine the timing of invasive non-invasive sequential mechanical ventilation treatment.In the experimental group,43 patients were selected to use PIC-W+SBT to determine the timing of invasive non-invasive sequential mechanical ventilation treatment.Compare the therapeutic effects of two groups.Results After treatment,the FEV1,FVC values,PaCO2,and SaO2 of the two groups of patients were significantly higher than before treatment,and the experimental group was higher than the control group(P<0.05).The PaO2 value,re intubation rate,mortality rate,and incidence of complications in the experimental group were lower than those in the control group after treatment(P<0.05).The total mechanical ventilation time and ICU hospitalization time in the experimental group were shorter than those in the control group(P<0.05).Conclusion Sequential mechanical ventilation based on lung infection control window combined with spontaneous breathing test timing is well tolerated in patients with acute exacerbation of chronic obstructive pulmonary disease,reducing the rate of re intubation and mortality.It has a positive effect on improving lung function,blood gas indicators,and reducing complications,and can be promoted and applied in clinical practice.
作者
姚园场
胡长新
肖文
YAO Yuan-chang;HU Chang-xin;XIAO Wen(Critical Care Medicine Department,Yongcheng City People's Hospital,Yongcheng 476600,Henan Province,China)
出处
《罕少疾病杂志》
2025年第1期68-70,共3页
Journal of Rare and Uncommon Diseases
关键词
慢性阻塞性肺疾病
肺部感染控制窗
自主呼吸试验
序贯机械通气
Chronic Obstructive Pulmonary Disease
Te Exacerbation
Pulmonary Infection Control Window
Spontaneous Breathing Test
Sequential Mechanical Ventilation
